Relationship between a Weighted Multi-Gene Algorithm and Blood Pressure Control in Hypertension

Abstract

Hypertension (HTN) is a complex disease with interactions among multiple organ systems, including the heart, vasculature, and kidney with a strong heritable component. Despite the multifactorial nature of HTN, no clinical guidelines utilize a multi-gene approach to guide blood pressure (BP) therapy. Non-smokers with a family history of HTN were included in the analysis (n = 384; age = 61.0 ± 0.9, 11% non-white). A total of 17 functional genotypes were weighted according to the previous effect size in the literature and entered into an algorithm. Pharmacotherapy was ranked from 1–4 as most to least likely to respond based on the algorithmic assessment of individual patient’s genotypes. Three-years of data were assessed at six-month intervals for BP and medication history. There was no difference in BP at diagnosis between groups matching the top drug recommendation using the multi-gene weighted algorithm (n = 92) vs. those who did not match (n = 292). However, from diagnosis to nadir, patients who matched the primary recommendation had a significantly greater drop in BP when compared to patients who did not. Further, the difference between diagnosis to current 1-year average BP was lower in the group that matched the top recommendation. These data suggest an association between a weighted multi-gene algorithm on the BP response to pharmacotherapy.

CACNA1C rs1006737 SNP increases the risk of essential hypertension in both Chinese Han and ethnic Russian people of Northeast Asia

“…EH is a complex and polygene genetic disease, evidence suggests that polymorphism of gene has been associated with EH in various populations. [ 19 – 23 ] Our study provides a China-Russia biracial view of hypertension in the same geographical region for the first time. Our main findings were that…”

Gene Therapy for Hypertension, Atherosclerosis, and Familial Hypercholesterolemia: The Old Concepts and the New Era

“…The NCT02524873 trial examined the genes involved in the pathogenesis of EH in adults. This study showed the interplay between gene polymorphisms and the correspondence to pharmacological therapy [90]. The MDR1 gene polymorphism does not decrease losartan concentration in plasma but offers a greater reduction in BP compared with the presence of the polymorphism [91].…”

The Importance and Challenges of Developing a Pharmacogenetics Test for Hypertension

“…This is particularly important in hypertension given the number of genes that are known to be associated with BP. Moreover, until whole genome sequencing and clinician understanding of whole genome sequencing is widespread, there needs to be transparent criteria for the genotypes selected that include allelic frequency (common and generalizable) and effect size (clinically meaningful) [11].…”